Testosterone
Replacement Therapy (TRT)

Clinical Studies & Research Library

Last updated: September 2025
Medically reviewed by Peter Fotinos, MD, and Lorna A. Brudie, DO.

Welcome to
evidence-based
hormone health

After decades of debate, large clinical trials and meta-analyses now provide clear answers. When prescribed responsibly and monitored properly, TRT is effective, safe, and life-changing for men with low testosterone and symptoms.¹ This research library summarizes the most important evidence across cardiovascular health, prostate safety, mental health, metabolism, aging, and treatment protocols. All content is reviewed by licensed physicians and updated regularly.

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Peter Fotinos, MD,
Chief Medical Officer

Medical review
and safety statement

This page was medically reviewed for accuracy and safety by Peter Fotinos, MD, Chief Medical Officer at Excel Medical, which includes Male Excel and Fem Excel. Dr Fotinos has nearly two decades of clinical experience in bioidentical hormone optimization for men and women, including testosterone, estradiol, thyroid, progesterone, and preventive medicine. He leads the design and oversight of Excel Medical’s treatment protocols with a focus on safety, effectiveness, and scientific integrity.

All content, protocols, and recommendations are based on peer-reviewed clinical studies and have been reviewed for medical accuracy, safety, and patient relevance as of September 2025.

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Dr. Lorna Brudie
Medical Director

Medical review
and safety statement

It was also reviewed by Lorna A. Brudie, DO, FACOG, FACS, Medical Director for Fem Excel and Male Excel. Dr Brudie is double board-certified by the American Osteopathic Board of Obstetrics and Gynecology and in Gynecologic Oncology, with expertise in hormone protocol safety, cancer risk assessment, and integrative care.

All content, protocols, and recommendations are based on peer-reviewed clinical studies and have been reviewed for medical accuracy, safety, and patient relevance as of September 2025.

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What Is Testosterone Replacement Therapy (TRT)?

TRT restores testosterone levels in men struggling with symptoms such as fatigue, muscle loss, increased fat, poor mood, and diminished libido.^15_17
Our approach is provider-supervised and guided by clinical data, ensuring safety and effectiveness.²⁵
At Male Excel, we deliver TRT through our proprietary Excel Advantage™ Protocol, developed by our Chief Medical Officer, Dr Peter Fotinos. Built on 30 years of combined clinical experience and real-world results, it combines daily microdosing, provider-led care, and regular lab monitoring to ensure the benefits proven in clinical trials translate into consistent, measurable outcomes for our members.^{19_21 26_27}

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Does TRT Work? Is TRT Safe? The Top Studies Say Yes.

Decades of research confirm that testosterone replacement therapy works and is safe when prescribed responsibly.^15_18 Large clinical trials and meta-analyses show that TRT improves energy, sexual health, mood, and body composition while carrying no increased risk of heart attack or stroke.^1_3 Modern evidence also finds no link between TRT and prostate cancer in men with appropriate screening.^{4_5 28 35} Authoritative guidelines from the Endocrine Society and other expert groups endorse TRT for men with low testosterone symptoms, provided treatment includes regular labs and medical oversight.²⁴

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Dangers of Estrogen Blockers (Aromatase Inhibitors) in Men

Male Excel does not prescribe aromatase inhibitors. Some clinics add them routinely to testosterone therapy to push estrogen lower, but research shows this approach can cause harm. Estradiol is essential for male bone strength, cardiovascular health, sexual function, mood, and metabolism. Blocking it unnecessarily has been linked to brittle bones, joint pain, erectile dysfunction, adverse cholesterol changes, low mood, and reduced quality of life.³¹–³⁴ We avoid aromatase inhibitors entirely because the evidence shows the risks far outweigh any potential benefit when treatment is properly monitored.^29_32

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Evidence in Men

Key studies:

Lower bone density with AI in older men

Burnett-Bowie SA, McKay EA, Lee H, Leder BZ.
Effects of aromatase inhibition on bone mineral density and bone turnover in older men with low testosterone levels. J Clin Endocrinol Metab. 2009;94(12):4785–4792.
In elderly hypogonadal men, anastrozole lowered estradiol and reduced lumbar-spine bone mineral density compared to placebo.
View on PubMed | Read Full Study (DOI)

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Aromatization is essential for bone and function

Finkelstein JS, Lee H, Burnett-Bowie SA, et al. Gonadal steroids and body composition, strength, and sexual function in men. N Engl J Med. 2013;369(11):1011–1022.
Testosterone’s benefits on bone strength and physical function depend on estradiol conversion; blocking estrogen removes these gains.
View on PubMed

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Insulin resistance with AI therapy

Gibb FW, Homer NZM, Ferenbach DA, et al. Aromatase inhibition reduces insulin sensitivity in healthy men: a randomized, double-blind, placebo-controlled crossover trial using stable isotope tracers. J Clin Endocrinol Metab. 2016;101(11):4254–4262.
A crossover trial in healthy men found that anastrozole reduced insulin sensitivity measured by gold-standard tracer methods.
View on PubMed | Read Full Study | DOI

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Lipid changes in elderly men on AI

Dougherty RH, Rohrer JL, Hayden D, et al. Effect of aromatase inhibition on lipids and inflammatory markers in elderly men with low testosterone levels. Clin Endocrinol (Oxf). 2005;62(4):449–455.
Randomized trial: Anastrozole was linked to unfavorable cholesterol changes after 12 weeks in hypogonadal men.
View on PubMed

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Long-term safety in men has not been established

de Ronde W, de Jong FH. Aromatase inhibitors in men: effects and therapeutic options. Reprod Biol Endocrinol. 2011;9:93.
Reviews note that while AIs raise testosterone levels, long-term male safety and outcomes remain unproven; routine use is not recommended.
View on PubMed | Read Full Review

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Why Estradiol Matters in Men

Low estradiol predicts fractures:
Multiple studies link low E2, not just low testosterone, to higher fracture risk in men.

Key studies:

Estradiol and Fracture Risk

Nethander M, Vandenput L, Eriksson AL, Windahl S, Funck-Brentano T, Ohlsson C. Evidence of a Causal Effect of Estradiol on Fracture Risk in Men. J Clin Endocrinol Metab. 2019;104(2):433-442. doi:10.1210/jc.2018-00934
Mendelian Randomization

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The Role of Estrogens in Male Bone Health

Vandenput L, Ohlsson C. Estrogens as regulators of bone health in men. Nat Rev Endocrinol. 2009;5(8):437-443. doi:10.1038/nrendo.2009.112
Review

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Hormone Levels and Fracture Risk in Aging Men

LeBlanc ES, Nielson CM, Marshall LM, et al.; Osteoporotic Fractures in Men Study Group. The effects of serum testosterone, estradiol, and sex hormone–binding globulin levels on fracture risk in older men. J Clin Endocrinol Metab. 2009;94(9):3337-3346. doi:10.1210/jc.2009-0206.
MrOS Cohort

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Key Takeaway

Blocking estrogen unnecessarily can weaken bones, harm heart health, reduce sexual function, and worsen mood. Male Excel avoids it unless clinically needed.^29_32

Male Excel’s Approach

We do not follow outdated shortcuts. At Male Excel, we never add aromatase inhibitors because the evidence is clear that blocking estrogen harms long-term health.^29_32

Our protocol relies on:

• Symptom-based dosing
• Maintaining optimal testosterone and estradiol levels for long-term health²⁴
• Daily microdosing to minimize testosterone troughs and prevent hormone fluctuations¹⁹
• Continuous provider oversight for effective, stable hormone conversion²⁴
• Expert in-house providers trained exclusively in the Excel Advantage™ Protocol

Clinics that use estrogen blockers automatically are not practicing evidence-based TRT. They’re following a playbook written by people who don’t know what they’re doing.

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Testosterone Creams
and Gels: The Evidence

Daily testosterone creams and gels offer a safe, flexible, and effective alternative to injections. Clinical research shows they achieve stable hormone levels, improve symptoms, and carry no additional cardiovascular or prostate risks.^{20_22 25_27}

Key Findings
(2016–2024)

High efficacy: 80–85% of men using daily testosterone gels reached normal testosterone levels with dose titration.

Stable hormone levels: Daily transdermal dosing maintained steady testosterone concentrations versus the fluctuations seen with intramuscular injections.

Flexible titration: Clinical trials used serum testosterone targets (350–750 ng/dL) for individualized dose adjustments.

Favorable safety profile: Skin irritation occurred in 5–6% of users. Long-term studies reported no increase in cardiovascular or prostate risk compared to injection therapy.

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Supporting
Studies

Wang C, et al. Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition parameters in hypogonadal men. J Clin Endocrinol Metab. 2000;85(8):2839–2853. PubMed
Dobs AS, et al. Efficacy and safety of testosterone gel in hypogonadal men: results of a multicenter study. J Sex Med. 2015;12(11):2189–2199. PubMed
Kaufman JM, et al. One-year efficacy and safety of 1.62% testosterone gel in hypogonadal men: 182-day open-label extension of a 6-month double-blind study. J Sex Med. 2012;9(4):1149–1161. PubMed

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Why It Matters

Daily topical dosing aligns with Male Excel’s philosophy of stable, youthful hormone levels. It supports:

Consistent hormone levels
Evidence-based safety monitoring
Individualized dosing for optimal symptom control

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Key Takeaway

Daily topical testosterone provides steady symptom relief with a strong safety record and flexible dosing for personalized care.^20_22

The Difference
Is in the Protocol.

At Male Excel, we do not just prescribe testosterone. Our Excel Advantage™ Protocol combines symptom-based assessments with daily testosterone microdosing, thyroid optimization, provider-led care, and regular lab monitoring to ensure the benefits proven in clinical studies translate into real-world results.^{19_22 26_27}

With decades of clinical experience and the leadership of Dr. Peter Fotinos, our approach reflects the latest research and best practices in hormone optimization. We move beyond outdated, one-size-fits-all protocols to deliver evidence-based, patient-focused treatment.
When you choose TRT with Male Excel, you are choosing a program built on science, safety, and long-term health outcomes under the care of one of the most experienced provider teams in the field.²⁴

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Testosterone Replacement Therapy (TRT):
Frequently Asked Questions

Here are the most common questions men ask about testosterone therapy, safety, and what to expect during treatment. Every answer is based on the latest clinical research and the protocols developed by Dr. Peter Fotinos and the Male Excel medical team.  

What is testosterone replacement therapy (TRT)?

TRT helps men restore how they used to feel. It targets the symptoms of low testosterone, including fatigue, low sex drive, mood changes, and loss of muscle tone, while supporting long-term health. Optimized testosterone levels are linked to better heart health, stronger bones, improved metabolism, and sharper mental focus.^{1_3 8_13 15_18 24} At Male Excel, treatment is guided first by symptoms and how you feel, with blood tests used to support and fine-tune your therapy.²⁴

How fast will I feel results?

Some men begin to notice improvements in energy, mood, and sexual function within the first few weeks, but it typically takes 6 to 12 months to feel fully optimal as testosterone levels stabilize and body composition changes occur. Improvements in muscle mass, bone density, and overall vitality continue to develop gradually with consistent therapy.^{34 6 13}

Is TRT safe long-term?

Yes. Large clinical trials and meta-analyses confirm that testosterone therapy is very safe when prescribed appropriately and monitored by qualified providers.^{1_3 15_18 24}

Will my doctor monitor me?

Yes, ongoing lab tests and medical reviews are required throughout treatment to ensure safety and effectiveness.²⁴

Does TRT increase heart or stroke risk?

Large trials (such as TRAVERSE) show no increased risk for heart attack or stroke with supervised TRT.^1_3

Does TRT cause prostate cancer or major urinary problems?

Recent studies show no meaningful increase in new prostate cancer or severe urinary complications when men are properly monitored.^{4_5 35}

What are the possible side effects of TRT?

Possible side effects include mild acne, fluid retention, nipple sensitivity, and reduced sperm count. A rise in red blood cell count may occur in some men, but this is not clinically significant when therapy is properly managed. Large, long-term studies confirm that testosterone therapy does not increase the risk of blood clots, heart attack, or stroke.^1_3

What forms of TRT exist?

TRT can be given as injections, gels, patches, creams, or implants. Each form varies in application, cost, convenience, and how steadily it delivers testosterone. The best form depends on individual health, medical history, and treatment preference. At Male Excel, our protocol is built around daily creams and subcutaneous injections, which clinical research and our outcomes show are highly effective and provide stable hormone levels for most men.^{19_22 26_27}

Can I stop TRT?

Yes, treatment can be stopped at any time, but symptoms of low testosterone are likely to return. Natural testosterone and fertility recover once therapy is discontinued, although the timeline varies between individuals.²⁴

Why
Male Excel
Is Different

Our Excel Advantage™ Protocol applies the latest clinical evidence, offering personalized, symptom-first care, ongoing safety checks, and continuous education.

“We don’t follow old rules. We created a better protocol,
and we back it with science.”

 — Dr. Peter Fotinos, MD, Chief Medical Officer

Sources & Methodology

All studies cited on this page were selected from peer-reviewed clinical journals indexed in PubMed, Scopus, or MEDLINE, with preference given to large randomized controlled trials, meta-analyses, and long-term safety data. Research was evaluated for sample size, design quality, and relevance to testosterone replacement therapy safety and efficacy. All content was medically reviewed by licensed physicians at Excel Medical and updated as of September 2025 to reflect the most current available evidence.^{13 24}

Sharma R, Oni O, Gupta K, et al. Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men. Eur Heart J. 2015;36(40):2706-2715. https://doi.org/10.1093/eurheartj/ehv346 | View on PubMed
Lincoff AM, Bhasin S, Flevaris P, et al. Cardiovascular safety of testosterone-replacement therapy. N Engl J Med. 2023;389(2):107-117. https://doi.org/10.1056/NEJMoa2215025 | View on PubMed
Cheetham TC, An J, Jacobsen SJ, Niu F, Sidney S, Quesenberry CP Jr. Association of testosterone replacement with cardiovascular outcomes among men with androgen deficiency. JAMA Intern Med. 2017;177(4):491-499. https://doi.org/10.1001/jamainternmed.2016.9546 | View on PubMed
Morgentaler A. Testosterone and prostate cancer: an historical perspective on a modern myth. Eur Urol. 2006;50(5):935-939. https://doi.org/10.1016/j.eururo.2006.06.034 | View on PubMed
Isbarn H, Pinthus JH, Marks LS, et al. Testosterone and prostate cancer: revisiting old paradigms. Eur Urol. 2009;56(1):48-56. doi:10.1016/j.eururo.2009.03.088 https://doi.org/10.1016/j.eururo.2009.03.088. | View on PubMed
Snyder PJ, Bhasin S, Cunningham GR, et al. Effects of testosterone treatment in older men. N Engl J Med. 2016;374(7):611-624. https://doi.org/10.1056/NEJMoa1506119 | View on PubMed
Traish AM. Testosterone therapy in men with testosterone deficiency: are we beyond the point of no return? Investig Clin Urol. 2016;57(6):384-400. https://doi.org/10.4111/icu.2016.57.6.384 | View on PubMed
Saad F, Gooren LJ. The role of testosterone in the metabolic syndrome: a review. J Steroid Biochem Mol Biol. 2009;114(1-2):40-43. https://doi.org/10.1016/j.jsbmb.2008.12.022 | View on PubMed
Haider KS, Haider A, Saad F, Doros G, Gooren LJ. Remission of type 2 diabetes following long-term treatment with injectable testosterone undecanoate in men with hypogonadism and type 2 diabetes: 11-year data from a real-world registry study. Diabetes Obes Metab. 2020;22(11):2055-2068. https://doi.org/10.1111/dom.14122 | View on PubMed
Wittert G, Grossmann M, Yeap BB, et al. Testosterone treatment to prevent or revert type 2 diabetes in men (T4DM): a 2-year, phase 3b randomized controlled trial. Lancet Diabetes Endocrinol. 2021;9(1):32-45. https://doi.org/10.1016/S2213-8587(20)30312-5 | View on PubMed
Grossmann M, Anawalt BD, Yeap BB. Testosterone therapy in older men: clinical implications of recent landmark trials. Eur J Endocrinol. 2024;191(1):R22-R31. https://doi.org/10.1093/ejendo/lvae071 | View on PubMed
Snyder PJ, Kopperdahl DL, Stephens-Shields AJ, et al. Effect of testosterone treatment on volumetric bone density and strength in older men with low testosterone. JAMA Intern Med. 2017;177(4):471-479. https://doi.org/10.1001/jamainternmed.2016.9539 | View on PubMed
Mohamad NV, Soelaiman IN, Chin KY. A concise review of testosterone and bone health. Clin Interv Aging. 2016;11:1317-1324. https://doi.org/10.2147/CIA.S115472 | View on PubMed
Elliott J, Kelly SE, Millar AC, et al. Testosterone therapy in hypogonadal men: a systematic review and network meta-analysis. BMJ Open. 2017;7(11):e015284. doi:10.1136/bmjopen-2016-015284 | View on PubMed
Corona G, Rastrelli G, Morgentaler A, Sforza A, Mannucci E, Maggi M. Meta-analysis of results of testosterone therapy on sexual function based on International Index of Erectile Function scores. Eur Urol. 2017;72(6):1000-1011. doi:10.1016/j.eururo.2017.03.032 | View on PubMed
Yang HJ, Kim KH, Kim DS, Lee CH, Jeon YS, Shim SR, Kim JH. The effect of testosterone replacement on sexual function in the elderly: a systematic review and meta-analysis. World J Mens Health. 2023;41(4):861-873. doi:10.5534/wjmh.220171 | View on PubMed
Sood A, Hosseinpour A, Sood A, et al. Cardiovascular outcomes of hypogonadal men receiving testosterone replacement therapy: a meta-analysis of randomized controlled trials. Endocr Pract. 2024;30(1):2-10. doi:10.1016/j.eprac.2023.09.012 | View on PubMed
Hackett G, Kirby M, Edwards D. Testosterone replacement therapy and prostate/cardiovascular safety: an updated systematic review. World J Mens Health. 2024;42(1):15-29. doi:10.3389/fendo.2024.1335146 | View on PubMed
Yazdani N, Kashani MN, Kashani HH, et al. Daily subcutaneous testosterone for management of testosterone deficiency. Front Biosci (Elite Ed). 2018;10(2):334-343. doi:10.2741/E825 | View on PubMed
Wang C, Swerdloff RS, Iranmanesh A, et al. Transdermal testosterone gel improves sexual function, mood, muscle strength, and body composition in hypogonadal men. J Clin Endocrinol Metab. 2000;85(8):2839-2853. DOI:10.1210/JCEM.85.8.6747 | View on PubMed
Dobs AS, Morgentaler A, Kaufman JM, et al. Efficacy and safety of testosterone gel in hypogonadal men: results of a multicenter study. J Sex Med. 2015;12(11):2189-2199. https://doi.org/10.1111/j.1743-6109.2011.02265.x | View on PubMed
Kaufman JM, Graydon RJ, Dobs AS, et al. One-year efficacy and safety of 1.62% testosterone gel in hypogonadal men: open-label extension of a double-blind study. J Sex Med. 2012;9(4):1149-1161. https://doi.org/10.1111/j.1743-6109.2011.02630.x | View on PubMed
Hackett GI. Long-term cardiovascular safety of testosterone therapy: review of TRAVERSE. World J Mens Health. 2025;43(2):282-290. https://doi.org/10.5534/wjmh.240081 | View on PubMed
Bhasin S, Brito JP, Cunningham GR, Hayes FJ, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. https://doi.org/10.1210/jc.2018-00229 | View on PubMed
Meikle AW, Matthias D, Hoffman AR. Transdermal testosterone gel: pharmacokinetics, efficacy of dosing, and application site in hypogonadal men. BJU Int. 2004;93(6):789-795. https://doi.org/10.1111/j.1464-410X.2003.04750.x | View on PubMed
Pastuszak AW, Gomez LP, Scovell JM, Khera M. Pharmacokinetics of testosterone therapies in relation to diurnal variation with aging. Andrology. 2022;10(1):90-103. https://doi.org/10.1111/andr.13108 | View on PubMed
Iyer R, Mok SF, Savkovic S, et al. Pharmacokinetics of testosterone cream applied to scrotal skin. Andrology. 2017;5(4):725-731. https://doi.org/10.1111/andr.12357 | View on PubMed
Morgentaler A, Traish AM. Shifting the paradigm of testosterone and prostate cancer: the saturation model and the limits of androgen-dependent growth. Eur Urol. 2009;55(2):310-320. doi:10.1016/j.eururo.2008.09.024 | View on PubMed
Burnett-Bowie SA, McKay EA, Lee H, Leder BZ. Effects of aromatase inhibition on bone mineral density and bone turnover in older men with low testosterone levels. J Clin Endocrinol Metab. 2009;94(12):4785-4792. https://doi.org/10.1210/jc.2009-0739 | View on PubMed
Gibb FW, Homer NZM, Ferenbach DA, et al. Aromatase inhibition reduces insulin sensitivity in healthy men: a randomized, double-blind, placebo-controlled crossover trial using stable isotope tracers. J Clin Endocrinol Metab. 2016;101(11):4254-4262. https://doi.org/10.1210/jc.2015-4146 | View on PubMed
Dougherty RH, Rohrer JL, Hayden D, et al. Effect of aromatase inhibition on lipids and inflammatory markers in elderly men with low testosterone levels. Clin Endocrinol (Oxf). 2005;62(4):449-455. https://doi.org/10.1111/j.1365-2265.2005.02205.x | View on PubMed
de Ronde W, de Jong FH. Aromatase inhibitors in men: effects and therapeutic options. Reprod Biol Endocrinol. 2011;9:93. https://doi.org/10.1186/1477-7827-9-93 | View on PubMed
Zarrouf FA, et al. (2009, Journal of Psychiatric Practice): Systematic review and meta-analysis of 16 clinical trials. Testosterone therapy significantly improved depressive symptoms in men with low testosterone, with no increase in adverse events. View on PubMed | DOI: 10.1097/01.pra.0000358315.88931.fc
Farid Saad, Antonio Aversa, Andrea M Isidori, Livia Zafalon, Michael Zitzmann, Louis Gooren, Onset of effects of testosterone treatment and time span until maximum effects are achieved, European Journal of Endocrinology, Volume 165, Issue 5, Nov 2011, Pages 675–685, https://doi.org/10.1530/EJE-11-0221
Bhasin S, et al. Prostate Safety Events During Testosterone Replacement Therapy in Men With Hypogonadism: A Randomized Clinical Trial. JAMA Network Open. 2023. | View on PubMed

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Testosterone Replacement Therapy (TRT)

Clinical Studies & Research Library

Welcome to evidence-based hormone health

Peter Fotinos, MD, Chief Medical Officer

Medical review and safety statement

Dr. Lorna Brudie Medical Director

Medical review and safety statement

What Is Testosterone Replacement Therapy (TRT)?

Does TRT Work? Is TRT Safe? The Top Studies Say Yes.

Cardiovascular Health & Longevity

Normalization of testosterone level is associated with reduced incidence of myocardial infarction and mortality in men

Cardiovascular Safety of Testosterone-Replacement Therapy

Association of Testosterone Replacement With Cardiovascular Outcomes Among Men With Androgen Deficiency

Prostate Health

Testosterone and Prostate Cancer: An Historical Perspective on a Modern Myth

Testosterone and Prostate Cancer: Revisiting Old Paradigms

Prostate Safety Events During Testosterone Replacement Therapy in Men With Hypogonadism: A Randomized Clinical Trial

Mental Clarity, Mood & Quality of Life

Testosterone and Depression: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effects of Testosterone Treatment in Older Men: Results From the Testosterone Trials

Metabolism, Diabetes Risk & Body Composition

The Role of Testosterone in the Metabolic Syndrome: A Review

Testosterone and Prostate Cancer: Revisiting Old Paradigms

Prostate Safety Events During Testosterone Replacement Therapy in Men With Hypogonadism: A Randomized Clinical Trial

Bone Health & Aging

Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low Testosterone: A Controlled Clinical Trial

A Concise Review of Testosterone and Bone Health

Meta-Analyses & Systematic Reviews

Elliott J, et al. (2017, BMJ Open)

Corona G, et al. (2017, European Urology)

Yang HJ, et al. (2023, World Journal of Men’s Health)

Sood A, et al. (2024, Endocrine Practice)

Specialized Protocols & Safety

Yazdani N, et al. (2018, Front Biosci):

McFarland J, et al. (2017, J Endocr Soc):

Shoskes JJ, Wilson MK, Spinner ML. (2016, Transl Androl Urol):

Dangers of Estrogen Blockers (Aromatase Inhibitors) in Men

Evidence in Men

Lower bone density with AI in older men

Aromatization is essential for bone and function

Insulin resistance with AI therapy

Lipid changes in elderly men on AI

Long-term safety in men has not been established

Why Estradiol Matters in Men

Estradiol and Fracture Risk

The Role of Estrogens in Male Bone Health

Hormone Levels and Fracture Risk in Aging Men

Male Excel’s Approach

Testosterone Creams and Gels: The Evidence

Key Findings (2016–2024)

Supporting Studies

Why It Matters

The Difference Is in the Protocol.

Testosterone Replacement Therapy (TRT): Frequently Asked Questions

Why Male Excel Is Different

Sources & Methodology

CONTACT

TREATMENTS

LEARN MORE

LEGAL

Testosterone
Replacement Therapy (TRT)

Welcome to
evidence-based
hormone health

Peter Fotinos, MD,
Chief Medical Officer

Medical review
and safety statement

Dr. Lorna Brudie
Medical Director

Medical review
and safety statement

Testosterone Creams
and Gels: The Evidence

Key Findings
(2016–2024)

Supporting
Studies

The Difference
Is in the Protocol.

Testosterone Replacement Therapy (TRT):
Frequently Asked Questions

Why
Male Excel
Is Different